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Anaesthesia healthcare workers' interactions with COVID-19-positive and -suspect patients: A multi-site observational study from Queensland, Australia. 麻醉医护人员与 COVID-19 阳性和可疑患者的互动：澳大利亚昆士兰州的一项多站点观察研究。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241265723
Adrian Chin, Christine Woods, Anita M Pelecanos, Angela Tognolini, Gunjan Chawla, Sheridan Bell, Ivan L Rapchuk, Jimmy Wang, Victoria A Eley
{"title":"Anaesthesia healthcare workers' interactions with COVID-19-positive and -suspect patients: A multi-site observational study from Queensland, Australia.","authors":"Adrian Chin, Christine Woods, Anita M Pelecanos, Angela Tognolini, Gunjan Chawla, Sheridan Bell, Ivan L Rapchuk, Jimmy Wang, Victoria A Eley","doi":"10.1177/0310057X241265723","DOIUrl":"10.1177/0310057X241265723","url":null,"abstract":"<p><p>Occupationally acquired COVID-19 is a hazard for healthcare workers (HCWs). In four hospitals of the Metro North Hospitals and Health Service in Queensland, Australia, we invited HCWs to report the nature of any anaesthesia interactions with COVID-19-positive and COVID-19-suspect patients. This was to assist workforce planning in future pandemics. Data collection consisted of three phases; 1) participating HCWs recorded details of episodes of care (EOCs) with COVID-19-positive or COVID-19-suspect patients; 2) these HCWs were invited to complete a follow-up survey about their own health status regarding COVID-19 infections; 3) electronic health records were used to assess patient demographics, infectious status and outcomes. Between 21 March 2020 and 17 May 2022, 63 anaesthesia HCWs reported 90 EOCs with 67 unique patients. The median (interquartile range (IQR)) age of the HCWs was 40.5 years (34-46); 55% (34/62) were male, 62% (39/63) were consultants and 21% (13/63) were registrars. The median (IQR) age of patients was 39 (28-63) years. Personal protective equipment (PPE) was deemed to be appropriate by the HCWs in (86/88) 98% of the EOCs. Twenty-four HCWs (38%) responded to a follow-up survey. Of 12 HCWs who subsequently tested positive to COVID-19, only four had cared for a COVID-19-positive patient in the two weeks prior to their diagnosis. Most responding HCWs perceived they contracted COVID-19 in the community, experiencing mild illness. We found relatively low COVID-19 case numbers, high PPE use and low transmission of COVID-19 within the hospital setting.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"377-385"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Skin injury: Associations with variables related to perfusion and pressure. 皮肤损伤：与灌注和压力相关变量的联系。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-12 DOI: 10.1177/0310057X241264575
Christopher J Roberts, Jennifer A Popies, Abrahim N Razzak, Xi Fang, Octavio A Falcucci, Paul J Pearson, Aniko Szabo
{"title":"Skin injury: Associations with variables related to perfusion and pressure.","authors":"Christopher J Roberts, Jennifer A Popies, Abrahim N Razzak, Xi Fang, Octavio A Falcucci, Paul J Pearson, Aniko Szabo","doi":"10.1177/0310057X241264575","DOIUrl":"10.1177/0310057X241264575","url":null,"abstract":"<p><p>Skin injuries are a major healthcare problem that are not well understood or prevented in the critically ill, suggesting that underappreciated variables are contributing. This pilot study tested the hypothesis that perfusion-related factors contribute to skin injuries diagnosed as hospital-acquired pressure injuries (HAPIs). A total of 533 adult patients were followed over 2574 critical care days (mean age 62.4, standard deviation (SD) 14.3 years, mean body mass index 30.4 (SD 7.4) kg/m<sup>2</sup>, 36.4% female). This was a secondary analysis of prospective, non-randomised clinical data from an intensive care unit at a large urban teaching hospital. Factors related to perfusion, specifically two or more infusions of vasopressors/inotropes, temporary mechanical circulatory support (MCS), extracorporeal membrane oxygenation, and durable MCS, were analysed to determine whether they were more strongly associated with HAPIs than immobility due to prolonged mechanical ventilation (>72 h) or operating room time (>6 h). Patients diagnosed with a HAPI had a statistically significant higher risk of being exposed to variables related to perfusion and immobility (<i>P</i> < 0.05 for each variable). Perfusion-related variables, except durable MCS, had a larger effect on skin breakdown (number needed to harm (NNH) 4-10) than immobility-associated variables (NNH 12-17). The finding that perfusion-related variables predicted HAPIs may warrant consideration of alternative diagnoses, such as skin failure due to impaired perfusion as a pathophysiological process that occurs concurrently with multisystem organ failure. Differentiation of skin injuries primarily from circulatory malfunction, rather than external pressure, may guide the development of more effective treatment and prevention protocols. This pilot study suggests that the contribution of perfusion to skin injuries should be explored further.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"386-396"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dr Gilbert Reynolds Troup: A founder of the Australian Society of Anaesthetists. 吉尔伯特-雷诺兹-特鲁普博士：澳大利亚麻醉师协会创始人。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 DOI: 10.1177/0310057X241267928
Michael G Cooper
{"title":"Dr Gilbert Reynolds Troup: A founder of the Australian Society of Anaesthetists.","authors":"Michael G Cooper","doi":"10.1177/0310057X241267928","DOIUrl":"https://doi.org/10.1177/0310057X241267928","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"52 1_suppl","pages":"3-5"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survival in hostile environments: The fight to understand and protect against acceleration-induced visual disturbance and loss of consciousness in pilots of powered, heavier-than-air aircraft. 在恶劣环境中生存：努力了解和防止动力重于空气的飞机飞行员因加速度引起的视觉干扰和意识丧失。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 DOI: 10.1177/0310057X241286298
Peter J Featherstone, Christine M Ball
{"title":"Survival in hostile environments: The fight to understand and protect against acceleration-induced visual disturbance and loss of consciousness in pilots of powered, heavier-than-air aircraft.","authors":"Peter J Featherstone, Christine M Ball","doi":"10.1177/0310057X241286298","DOIUrl":"https://doi.org/10.1177/0310057X241286298","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"52 6","pages":"348-350"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comprehensive audit of difficult airway trolleys in selected Victorian hospitals. 对维多利亚州部分医院的困难气道推车进行全面审计。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-09-23 DOI: 10.1177/0310057X241265722
Yaodong Tang, Teresa Pham, William Pl Bradley, Fiona M Brewster, David J Brewster
{"title":"A comprehensive audit of difficult airway trolleys in selected Victorian hospitals.","authors":"Yaodong Tang, Teresa Pham, William Pl Bradley, Fiona M Brewster, David J Brewster","doi":"10.1177/0310057X241265722","DOIUrl":"10.1177/0310057X241265722","url":null,"abstract":"<p><p>This study aimed to assess the availability, design, and contents of difficult airway trolleys in hospitals in Victoria, Australia. A survey audit was conducted with a 92.3% reply rate, and the responses from 22 major Victorian hospitals were analysed. The results showed that difficult airway trolleys were available in 100% of operating theatres, emergency departments and intensive care units, and the rate of standardisation was high. Compliance with recommended design features and resources was on average 68.3%. There was no significant difference in the compliance rate of major tertiary centres compared with other hospitals. The carriage of non-essential items was reduced compared with earlier audits. However, there was heterogeneity in the brands of supraglottic airway devices, videolaryngoscopes and cognitive aids used. The study highlights the need for ongoing improvement to the organization and content of difficult airway trolleys, and for further discussion regarding the safety of equipment variation across institutions.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"407-414"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case of cardiorespiratory collapse following bilateral sub-Tenon's blocks from brainstem anaesthesia. 一例脑干麻醉后双侧腱膜下阻滞后心肺功能衰竭的病例。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-09-23 DOI: 10.1177/0310057X241265729
Steven C Cai, Anne-Marie Amie W Dempster, Alfred Wy Chua
{"title":"A case of cardiorespiratory collapse following bilateral sub-Tenon's blocks from brainstem anaesthesia.","authors":"Steven C Cai, Anne-Marie Amie W Dempster, Alfred Wy Chua","doi":"10.1177/0310057X241265729","DOIUrl":"10.1177/0310057X241265729","url":null,"abstract":"<p><p>Sub-Tenon's block has a superior safety profile and life-threatening complications such as cardiovascular collapse and brainstem anaesthesia are extremely rare. We report a case of cardiorespiratory collapse following bilateral sub-Tenon's blocks at the conclusion of a laser photocoagulation procedure under general anaesthesia. The cause was most likely brainstem anaesthesia. We explore and discuss the likely mechanisms and other potential differential diagnoses. It highlights the importance of maintaining vigilance following an eye block. Attention should not falter upon completing a block or at the conclusion of a case, regardless of its type or safety profile. This case also illustrates how the presence of general anaesthesia may obscure and delay the diagnosis of brainstem anaesthesia.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"415-419"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comment on the clinical experience of cardiothoracic anaesthesia trainees in a tertiary Australian hospital. 对澳大利亚一家三级医院心胸麻醉实习生临床经验的评论。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241272109
Lay Teng Tan, Ivan L Rapchuk
{"title":"A comment on the clinical experience of cardiothoracic anaesthesia trainees in a tertiary Australian hospital.","authors":"Lay Teng Tan, Ivan L Rapchuk","doi":"10.1177/0310057X241272109","DOIUrl":"10.1177/0310057X241272109","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"429-431"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MET call prevention. 防止 MET 呼叫。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-09-03 DOI: 10.1177/0310057X241261392
William Pl Bradley, Simon Reilly, Alexander D Smith
{"title":"MET call prevention.","authors":"William Pl Bradley, Simon Reilly, Alexander D Smith","doi":"10.1177/0310057X241261392","DOIUrl":"10.1177/0310057X241261392","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"427-428"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraoperative 'pressure field' haemodynamic monitoring in a patient with severe aortic regurgitation having laparoscopic robot-assisted colorectal surgery. 对一名接受腹腔镜机器人辅助结直肠手术的重度主动脉瓣反流患者进行术中 "压力场 "血流动力学监测。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241263115
Walston R Martis, Charles Allen, Rajib Ahmed, Hilmy Ismail, Stephen Woodford, Bernhard Riedel
{"title":"Intraoperative 'pressure field' haemodynamic monitoring in a patient with severe aortic regurgitation having laparoscopic robot-assisted colorectal surgery.","authors":"Walston R Martis, Charles Allen, Rajib Ahmed, Hilmy Ismail, Stephen Woodford, Bernhard Riedel","doi":"10.1177/0310057X241263115","DOIUrl":"10.1177/0310057X241263115","url":null,"abstract":"<p><p>Laparoscopic robot-assisted colorectal surgery can pose significant haemodynamic challenges for patients with severe aortic regurgitation. The increased afterload caused by pneumoperitoneum and aortic compression, along with concurrent factors like hypercarbia, Trendelenburg positioning and ventilatory impairment, can worsen aortic regurgitation, leading to myocardial ischaemia and heart failure. Transoesophageal echocardiography (TOE) assists haemodynamic management intraoperatively but requires subspecialist skills and enables limited inferences to be drawn regarding the impact of afterload on myocardial performance. Minimally invasive haemodynamic monitoring enabling real-time visualisation of a patient's 'pressure field' has been suggested as a potential adjunct or alternative to TOE, with the added advantage of providing continuous quantitative information about both stroke volume and the afterload to ventricular ejection in a single visualisation. We describe an example of successful concurrent use of pressure field haemodynamic monitoring and TOE in a patient with severe aortic regurgitation having a prolonged laparoscopic robot-assisted pelvic exenteration.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"420-426"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
JG Farrell and The Lung: An early description of intensive care delirium in literature. 法雷尔与肺:重症监护谵妄的早期文献描述。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2023-11-25 DOI: 10.1177/0310057X231178836
John G O'Connell, Finbarr J Condon-English, Brian P O'Brien
{"title":"JG Farrell and <i>The Lung</i>: An early description of intensive care delirium in literature.","authors":"John G O'Connell, Finbarr J Condon-English, Brian P O'Brien","doi":"10.1177/0310057X231178836","DOIUrl":"10.1177/0310057X231178836","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"21-25"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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